Primary renal angiosarcoma with extensive hemorrhage: CT and MRI findings

ABSTRACT Primary angiosarcomas of the kidney are very rare, but highly aggressive tumors showing poor prognosis. Patients frequently complain of flank pain, hematuria, or a palpable mass. We present a case of primary renal angiosarcoma occurring in a 61-year-old man. CT images depicted a huge exophytic mass (16 cm in diameter) in the right kidney, exhibiting extensive hemorrhage. The mass showed centripetal peripheral nodular enhancement on dynamic contrast-enhanced images. Furthermore, MR imaging revealed a tangled mesh of tumor vessels in the periphery of the mass. We suggest its inclusion in the differential diagnosis of cases of hemorrhagic renal tumors with prominent vasculature.

摘要：肾脏原发性血管肉瘤（primary angiosarcoma of the kidney）极为罕见，却是一类极具侵袭性的恶性肿瘤，预后不良。患者常表现为胁腹疼痛、血尿或可触及的腹部肿块。本文报告1例发生于61岁男性的肾脏原发性血管肉瘤病例：计算机断层扫描（CT）影像显示其右肾存在一枚直径16cm的巨大外生性肿块，伴广泛出血；动态增强扫描图像可见该肿块呈向心性外周结节样强化。此外，磁共振成像（MR imaging）显示肿块周边存在紊乱交织的肿瘤血管网。本文建议，对于伴显著血管结构的出血性肾肿瘤病例，应将肾脏原发性血管肉瘤纳入鉴别诊断范畴。